在食道癌症的新辅助和辅助疗法
Jennifer A Weiss1, Shikha Jain1
1Division of Hematology and Oncology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
Journal of gastrointestinal oncology
|September 18, 2023
概括
食道癌的治疗方法结合了化疗,辐射和手术. 免疫疗法显示出前景,辅助剂尼沃卢马布在经过新辅助化学辐射和切除后推用于晚期阶段.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
背景情况:
- 食道癌是一种高死亡率的恶性瘤,需要多式治疗.
- 状细胞癌 (SCC) 和腺癌 (AC) 的最佳治疗策略正在发展.
- 目前的标准包括新辅助化学辐射,然后进行手术 (CROSS试验) 或非手术候选人的最终化学辐射.
研究的目的:
- 审查目前对食道癌的治疗方法,包括多模式策略和新兴疗法.
- 根据最近的临床试验,讨论新辅助,周术和辅助治疗的作用.
- 突出免疫疗法在术后和辅助环境中的潜力.
主要方法:
- 对具有里程碑意义的临床试验 (CROSS,MAGIC,FLOT4,CheckMate 577) 和正在进行的研究进行审查.
- 对不同食道癌亚型和阶段的治疗结果的分析.
- 在新辅助/辅助环境中评估向疗法和免疫疗法.
主要成果:
- 经过手术后的新辅助化学辐射是局部晚期切除性疾病的标准.
- 周围手术化疗是低食道和胃食道结合腺癌的选择.
- 如果存在残留疾病,建议在neoadjuvant化学辐射和切除后使用辅助性nivolumab.
结论:
- 根据组织学和阶段量身定制的多式疗法对于食道癌症的治疗至关重要.
- 免疫疗法,特别是辅助剂尼沃卢马布,代表了治疗后环境的重大进步.
- 目前正在进行的试验正在调查新的组合和序列,包括免疫疗法,以改善结果.
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